Can’t Catch My Breath

Abstract

Shortness of breath is one of the most common symptoms among pediatric palliative patients and can cause significant distress in patients and their caregivers. Dyspnea assessments highlight the patient’s subjective report as crucial to the evaluation and treatment of dyspnea. Symptom-directed treatments such as opioids and benzodiazepines should be given if disease-directed treatments are insufficient in providing dyspnea relief. In cases of dyspnea due to end-stage illness, palliative sedation or chronic mechanical ventilation via tracheostomy may need to be considered depending on the patient’s goals of care. This chapter presents a systems-based approach to evaluating and treating common causes of dyspnea in pediatric palliative care patients.